Chapter 23 and 24 Cancer Flashcards
Benign tumor cells
These cells do not invade, the don’t migrate, and have orderly growth
tumor angiogenesis factor (TAF)
When tumor is 1 cm
triggers capillaries and other blood vessels in the area to grow new branches into the tumor
Bloodborne metastasis
most common cause of cancer spread
Gx
grade can not be determined
G1
tumor cells are well differentiated and closely resemble the normal cells from which they arose
G2
tumor cells are moderately differentiated- they still retain some of the characteristics of normal cells
G3
tumor cells are poorly differentiated and retain no normal cell characteristics
Ploidy
the description of cancer cells by chromosome number and appearance. Normal human cells have 46
TNM system
Tumor, node, metastasis system describes the anatomic extent of cancers
not useful for leukemia or lymphomas.
Tx
Primary tumor cannot be assessed
T0
no evidence of primary tumor
Tis
carcinoma in situ (in its natural or original place)
Nx
regional lymph nodes cannot be assessed
N0
no regional lymph node metastasis
M0
no distant metastasis
M1
distant metastasis
Mitotic index
the percentage of actively dividing cells within a tumor
85%- fast growing tumor
Viral carcinogens examples
Eptein-Barr virus, hep B and hep C, HPV
Biggest CA risk factor
age (>60)
7 warning signs of CA
CAUTION
C- changes in bowel or bladder habits A- A sore throat that does not heal U- Unusual bleeding or discharge T- Thickening or lump in the breast or elsewhere I- Indigestion or difficulty swallowing O- Obvious change in a wart or mole N- Nagging cough or hoarseness
Cancer that invades the bone marrow causes what?
anemia, thrombocytopenia, and reduce production of healthy WBC’s
Cancer that spreads to the liver causes what?
malnutrition and death
Radiation tx
destroys cancer cells with minimal exposure to normal cells
local treatment
Radiation dose
amount of radiation absorbed by the tissue
always less than exposure
Teletherapy
radiation source is external to the PT
PT is not radioactive
Brachytherapy
radiation in direct, continuous contact with the tumor
the patient emits radiation and is hazardous to others for 48 hours after
Chemotherapy
major tx
has some selectivity for killing CA cells over normal cells
Types of normal cells effected by chemotherapy
those that divide rapidly such as skin, hair, intestinal tissues, spermatocytes, and blood forming cells
Nadir
the time when bone marrow activity and WBC counts are at their lowest level after chemo
Frequency of chemotherapy administration
every 3-4 weeks
on average 4-12 times
Extravasation
the major complication of IV infusion
drug leaks into the surrounding tissues
can cause severe tissue damage
Surgery may be needed
Side effects of chemo
anemia thrombocytopenia neutropenia mucositis changes in cognitive function N/V peripheral neuropathy
Neutropenia
greatly increases risk for infection and can cause death
Neutropenia tx
BMR’s (biologic response modifier) to stimulate bone marrow production
BMR’s ex
neupogen, procrit/epogen, neumega
Thrombocytopenia
increases risk for bleeding
<20K platelets may have spontaneous bleeding and need a transfusion
Mucositis
open sores on mucous membrane
especially stomatitis
PT should drink 3L of H2O daily
Hormonal manipulation
aimed at decreasing hormones to slow CA growth
Tamoxifen
estrogen antagonist-agonist
used to tx breast CA
binds to estrogen so it is unavailable for cells
Tamoxifen se
hot flashes and wt gain increased hair growth decreased breast tissue or gynnecomastia in men sexual disfunction increased risk of DVT
Photodynamic therapy
Selective destruction of cancer cells through a chemical reaction triggered by different types of laser light
Dye is administered IV and collects in CA cells in 2-3 days
Photodynamic therapy se
photosensitive for 12 weeks (sunblock will not prevent sunburn)
eye/skin pain
Oncologic Emergencies
sepsis disseminated intravascular coagulation (DIC) SIADH spinal cord compression hypercalcemia superior vena cava syndrome
disseminated intravascular coagulation (DIC)
often caused by sepsis
seen in leukemia
clotting followed by bleeding
disseminated intravascular coagulation (DIC) sx
pain, strokelike symptoms, dyspnea, tachycardia, oilguria, and tissue death
SIADH sx and tx
hyponatremia, weakness, muscle cramps, fatigue, loss of appetite, seizures, coma
tx: Fluid restrictions
Hypercalcemia
usually seen in bone CA
Hypercalcemia sx and tx
Fatigue, N/V, constipation, polyuria, etc
tx: Increase hydration, calcitonin
Superior vena cava syndrome
Occurs from compression of the SVC
Superior vena cava syndrome sx
edema of the face especially around the eyes upon awakening, tightness of the shirt collar, edema in the arms and hands, dyspnea, erythema of the upper body, nose bleeds, ALOC
